AKI in COVID-19: Incidence and Outcomes

NKF Spring Clinical Meetings 2021

The pandemic of COVID-19 has had a negative impact on various organ systems and on individuals of all ages. Kidney involvement in patients with COVID-19 typically manifested as acute kidney injury (AKI). However, there are few consensus data on the epidemiology of AKI in COVID-19. Ronith Chakraborty and colleagues conducted a systematic literature review to assess the knowledge gap

Results of the review were reported during a virtual poster session at the NKF Spring Clinical Meetings 2021 in a poster titled A Systematic Review of the Incidence and Outcomes of Acute Kidney Injury in COVID-19.

The researchers systematically searched Medline and Cochrane Library for literature related to AKI in COVID-19 in patients of all ages. In addition, MEDRxIV was searched for relevant unpublished manuscripts. The literature was independently assessed by two reviewers. Relevant studies assessed the incidence of AKI and the association with mortality, extracting the need for kidney replacement therapy (KRT).

The review included 60 studies, representing 43,871 patients. The pooled incidence of AKI among patients with COVID-19 was 19.45% (95% confidence interval [CI], 14.63% to 24.77%); the pooled incidence of COVID-19 patients with AKI who required KRT was 39.04% (95% CI, 16.38% to 64.57%). The pooled proportion of COVID-19 positive patients was significantly lower at 8.83% (95% CI, 5.64% to 12.66%).

The overall mortality of patients with COVID-19 was calculated as 17.71% (95% CI, 11.49% to 24.93%). Mortality among patients with COVID-19-related AKI was 54.24% (95% CI, 44.70% to 63.63%).

In conclusion, the researchers said, “This review found significantly higher incidence and mortality rates in COVID-19 patients with AKI, especially those requiring KRT. This suggests that kidney involvement during COVID-19 is substantial, requiring additional studies to explore KRT treatments.”

Source: Chakraborty R, Mahajan Z, Vasistha P, et al. A systematic review of the incidence and outcomes of acute kidney injury in COVID-19. Abstract of a poster presented at the National Kidney Foundation virtual Spring Clinical Meetings 2021 (Poster #6), April 9, 2021.